The Reality of Navigating the Mental Health System as a Black Woman

At the age of 13, I experienced my first serious bout of depression and anxiety. What I was experiencing included mainly an uncontrollable, relentless chokehold of self-hatred and hopeless despair. Of course, I didn’t know then that these intense mood swings constituted a mental illness. I just knew that these gruesome waves of sadness went beyond teenage angst. I was trapped in a sealed bell jar, despondent on the outside, crawling out of my skin on the inside.

The initial thought of seeking help seemed painfully daunting. Yet as the depressive episodes deepened in duration and intensity, I understood that I couldn’t continue to exist in a constant state of debilitating emotional turbulence — I wanted relief from the looped agony of living. Unfortunately, there were considerable obstacles in the way of getting help. As a black woman who grew up in a painfully white suburb in Connecticut, it was an anomaly to encounter people who looked like me. The prospect of finding a black therapist seemed like an impossible feat. Although the financial aspect wasn’t necessarily a prohibiting factor, I felt burdened by an immense sense of shame and embarrassment.

At the time, however, both of my parents were susceptible to the cultural stigma surrounding therapy — in their eyes, allowing their teenage daughter to get professional help meant that they had royally failed as parents. My father, a black man who had grown up in the same town I called home, had been instilled with the mantra of “not airing your dirty laundry out in public.” He viewed therapy as not only a violation of his privacy, but a practice largely for and exhibited by white people. My mother, an Asian immigrant, didn’t believe in the idea of paying someone to listen to all of your problems. Not only did she believe it would dishonor the family, but she also saw it as an unnecessary luxury. For my parents, though they certainly meant well, therapy was just something people of color didn’t do. My parents weren’t alone in their beliefs.

And yet, according to the Health and Human Services Office of Minority Health, “African Americans are 20 percent
more likely to experience serious mental health problems than the general population.” While the term “self-care” has slowly but surely seeped into our cultural vocabulary, discussing the topic of mental health, especially within the black community, is still stigmatized.

Asking for help is viewed as a sign of weakness, a deeply troubling character flaw. Instead of turning to a therapist or counselor, many black folks suffer in silence. The idea of resilience becomes not only harmful, but a form of unwanted emotional labor. A plethora of reasons, including inherent cultural biases, routinely prevent members of the black community from seeking professional help.

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According to Joy Harden Bradford, a licensed psychologist in the state of Georgia, there are a few common factors that prevent members of the black community from seeking help. She is also the founder of Therapy for Black Girls, an online platform committed to providing black women and girls with knowledge about mental health and wellness. In an email interview with me, Bradford mentioned uncertainty as a pervasive factor.

My mental health journey hasn’t been easy, but the relief that came
with finding a black therapist was essential.

Bradford says, “I think that a lot of people are still unsure about what happens when you go to therapy, and I also think that a lot of people have had very hurtful and harmful experiences in therapy which makes them less likely to want to return.”

Although my father had never gone to therapy himself, he harbored preconceived notions about what a typical session entailed. His idea of therapy revolved around someone lying on a couch and revealing shameful, long-buried family secrets. Bradford believes that misinformation can be battled with education. She says that the first step in changing public perception of therapy, especially information about what therapists actually do and the tools they offer, starts with education.

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Certainly, education could help combat the stigma and even repair the lack of trust toward therapy displayed by members of the black community like my father. For others, myself included, we’ve internalized the demands of our racist and sexist society, where stereotypes such as the “Strong Black Woman” discourage asking for help. Bradford herself has found the stereotype has been damaging in a number of ways. She tells Allure, “I think that black women are often so busy tending to and taking care of other people that they are not always paying attention to what’s going on with themselves.... I also think that in many ways we’ve been socialized to think we don’t need to reach out for help, that we can figure it out on our own which of course is a barrier to starting therapy.”

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There are other reasons that members of the black community avoid seeking therapy. Reluctance to enlist the aid of a mental health professional can also include a lack of affordable and accessible health care and a lack of representation. According to the American Psychology Association, the demographics for active psychologists working within the United States from 2005 to 2013 were overwhelmingly white. The APA found that in 2013, white people made up 83.6 percent of active psychologists. On the other hand, only 5.3 percent of psychologists were black/African-American, while racial/ethnic minority groups overall were 16.4 percent of the active workforce.

Until I went off to college and could use the Student Health Services, I did my best to ignore my depression. Even then, it wasn’t until after I’d graduated that I found a therapist to go to who was a black woman. An article published by the Journal of Counseling Psychology says, “A 2007 survey of 20,046 American Psychological Association (APA) members indicated that 86 percent of respondents already provide services to racial and ethnic minority clients (APA Research Office, 2003). However, the bulk of these services continue to be provided by White, European American therapists despite efforts to diversify the mental health workforce.”

For black men and women, the hurdles linked to seeking out a therapist
or a counselor can seem insurmountable.

Bradford doesn’t attribute this lack of diversity to one singular reason. In addition to the amount of required schooling, which consists of a bachelor’s degree and at least a master’s degree, followed by typically one to two years of postgraduate supervision, postgraduate programs are not always “affirming and welcoming.” Finally, a lack of awareness about the career path itself can deter a diverse demographic. She notes, “For a long time, I think that people have believed that being a therapist cannot be a pathway that leads to wealth and considerable financial compensation, and I don’t believe that to be true. There are tons of different ways our degrees and skills are marketable.”

My own mental health journey hasn’t been easy, but the sense of relief that came along with finding a black therapist was essential to creating a path towards wellness. For once, I didn’t feel like I needed to censor my thoughts when it came to issues regarding race and racism. The fear of appearing too sensitive or misunderstood slowly but surely disappeared. It wasn’t a magic fix, but it allowed the work needed for achieving and maintaining mental wellness to begin.

The ability to truly “be seen” is definitely a good starting place, Bradford tells me. She explains, “There will likely be some cultural nuances that will not need to be explained and it can just make one feel more open to share what’s happening with them. I will add though, that simply seeing another black woman is not enough if she is not skilled in working with the particular issue you need assistance with.”

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Like the cultural stigma that surrounds mental health services, the issue of underrepresentation in the psychology field won’t be solved overnight. For black men and women, the hurdles linked to seeking out a therapist or a counselor can seem insurmountable. Yet for those who are willing and able to not only seek help but find a mental health professional that looks like them, the benefits can be undeniably affirming. Bradford says, “It’s important to realize that mental health is something we all have, just like we all have physical health.” Black therapists may not currently be in abundance, but they exist. For many potential black patients, having someone who understands the nuances of how racial identity factors into mental health means a safe space where one’s voice is finally heard.